GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care:...

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GM Health and Social Care Workforce: Labour Market Information Report August 2017 V2.2

Transcript of GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care:...

Page 1: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

GM Health and Social Care Workforce: Labour Market

Information Report

August 2017

V2.2

Page 2: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

Purpose of the LMI Report

• Greater Manchester’s Healthcare Labour Market Information (LMI) Report aims to provide reliable statistical data regarding GM’s

workforce employed in the health and social care sector (henceforth HSC). It seeks to understand existing workforce structures

and dynamics as well as anticipated future demands.

• The document uses multiple sources of evidence, including national datasets and management data supplied by HSC

employers.

• It aims to supply a consistent measurement vehicle for understanding GM’s workforce that can be updated at regular intervals

with new data.

• The analysis outlines the latest position on skills supply and demand and seeks to inform Greater Manchester’s thinking on how

to develop its HSC workforce in the light of devolution.

• It focuses on the risks and opportunities facing the healthcare workforce at a time of political and fiscal uncertainty that has

followed the decision in June 2016 to leave the European Union.

• The LMI report supports the GM Workforce Strategy and Implementation plan. It should also be read in conjunction with several

other important documents, such as the Healthcare and Health Innovation Deep Dive and the Locality Plans which set out the

priorities and approach of the GM districts to workforce development. Links to these documents can be found in the further

reading slide at the end of this document.

GM H&S Care Workforce Strategy

Healthcare and Health Innovation Deep Dive

Locality plansGM H&SC LMI

ReportSpecific studies – e.g. Hard to fill reports

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Table of Contents

Context (global, national and GM) 6

Workforce Overview 10

Labour Forecasts 22

Vacancies 28

Specialist Staffing Areas 35

Skills Supply and Apprenticeships 41

Carers and the Voluntary Sector 49

HSC Workforce in GM Districts 52

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Main Messages

• HSC Employment: The HSC sector employs just under 13% of GM’s labour force or about 177,000 people, following rapid

growth (a 46% increase) since the early 1990s. Over a quarter of these jobs were in the Manchester district where the principal

employment sites are located. The GM HSC labour force has a lower rate of self-employment than other sectors (about 10%

compared with 13% in the wider GM economy), but a much higher rate of part-time working: almost 40% are part-time compared

with about a quarter elsewhere.

• Shortages: Although shortages and recruitment challenges are longstanding problems, the sector faces undoubted

contemporary recruitment difficulties which have been exacerbated by Brexit. Shortages affect areas such as nursing and

midwifery (about 1,200 are needed each year in GM), some areas of medical practice (about 300 doctors needed), and

professional practice areas such as radiology and radiography and children’s services; but a disproportionate amount of the

demand for new recruits in HSC is driven by care (about 8,500 a year – about 2,000 managers and about 6,500 care staff).

Churn in care (turnover rates of 31% and vacancy rates of 5.4%), often generated by job quality issues such as pay, hours and

stress contribute to demand.

• Forecasts: Forecasting suggests the GM HSC sector needs about 17,000 people a year largely driven by ‘replacement’ of staff

rather than ‘expansion’ of the sector. By 2035 forecasts, derived from the Greater Manchester Forecasting Model, suggest it will

employ between 190,000 and 200,000 people, depending on growth and population assumptions used in the forecast.

• Skills supply: This demand for staff within HSC raises questions about the ability of GM both to attract experienced

professionals to the city region and about the ‘home-grown’ skills supply system. In total, GM has about 17,000 people who

study HSC-relevant subjects at University each year (of which about 3,400 are medicine and dentistry), about 10,000

apprentices (almost all of whom are studying social care) and about 14,000 course starts in HSC related courses in the further

education system. In medicine and dentistry, GM retains about 35% of the graduates who study at GM based HEIs. In subjects

allied to medicine the proportion is 61%.

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Main Messages (cont.)

• Skills of existing workforce: Change within the sector implies the need for new ways of working, often enabled by ICT. Routes

and funding streams for people to balance working with flexible learning and clear pathways into HSC careers will be needed.

• Volunteers and carers: As well as staff employed conventionally in the HSC sector there is also human capital involved in the

voluntary sector and through caring by relatives and friends. About 10% of the population – or over 280,000 people – care for

others, with those devoting more than 50 hours a week to caring higher than national norms.

• Vacancies: Between January and July 2017, the HSC sector advertised 17,000 posts. Nurses were the largest single category

of recruitment (4,600 adverts) but care staff and managers and associate health professionals were also in demand. About a

third of adverts were for positions demanding at least a Bachelor’s degree.

• Ageing workforce: Recruitment challenges are likely to be exacerbated by the ageing workforce. In residential care almost half

of staff are aged over 50, a higher proportion than national norms.

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Global context

• 12% of NHS staff are citizens of other countries; 5.5% are from the EU. This is roughly the same as the wider economy.

• About 90,000 of the health workforce of 1.3m comes from EU. The number of non-British EU nationals working in the care

system has increased by 40% in three years

• Brexit: Leaving the EU is one of the central challenges to the health and social care workforce. For example, EU nationals

registering as nurses in the UK have dropped by 96% since the referendum (Nursing and Midwifery Council). Uncertainty over

residency and a weakened pound are two contributing factors.

• Global workforce demand: There is increased demand across the world for skilled healthcare staff. For example, the Association

of American Medical Colleges estimates a shortage of doctors across the US of 40,800 to 104,900 by 2030.

• The North West is an area with a lower than average use of NHS staff from outside the UK.

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• Totals: The NHS employs 1.4m people; social care 1.6m

• Shortages: Healthcare services, both within the NHS and wider care-giving sector, face acute demand pressures against the

background of an ageing society and public sector austerity. Despite rapid growth in the employment of nurses, demand

continues to outstrip supply. NHS Improvement estimates 15,000 more were needed in 2016. In June 2017 it was reported that

22 out of 69 trusts running community hospitals have not met their targets for nurse staffing in the last 2 years to March 2017.

(The Nursing Times)

• Agencies: This has led to an increase in the use of agency nurses. Agency staff cost the NHS £3.8 billion in 2016, while agency

staff costs rose by 30% between 2012 and 2015. In social care, 10% of staff are not permanent (The Health Foundation).

• Planning Long training times among doctors – it can take a decade or more to train a consultant - makes workforce planning

and supply/demand matching difficult. Regarding consultants, both the supply and demand of NHS consultants has increased

since the late 1990s. In recent years the supply of consultants has increased faster than activity. While consultant activity rose by

18% between 2007 and 2012, the number of consultants grew by 22%.

• Vacancies: The Office for National Statistics reported in February 2017 that 117,000 job vacancies in health and social care

were advertised for the 3 months to January 2017 – 15% of all job vacancies in the UK. Skills for Care reports that there are

90,000 vacancies for social care at present. Social worker vacancy rates stood at 11% for 2016. The Royal College of Nursing

states that there are 24,000 nursing vacancies with 11.1% of nursing posts unfilled. The Royal College of Midwives highlights a

shortage of 3,500 midwives.

• Quality: Staff shortages link to quality. Some 47% of staff said that staffing levels were insufficient for them to be able to do their

jobs properly (NHS Staff Survey 2016). Reports have repeatedly highlighted staff shortages as a factor in quality issues (e.g.

Francis Report 2013, Cavendish Review 2013, Berwick Review 2013, Keogh Mortality Review 2013 and Winterbourne 2012).

• Patient experience: The Kings Fund highlights that 2.5 million patients waited longer than 4 hours for treatment – an increase of

685,000 on the year before; 362,000 patients waited longer than 18 weeks for hospital treatment, up by 64,000. In social care,

The Health Foundation highlight that despite the number of people aged over 65 living in England increased by 170,000 in 2016.

Meanwhile, the number of people receiving funded care fell by 2%

• Morale: In the NHS Staff survey 2016, nearly 2 in 5 staff said that they had been ill in the last 12 months due to work-related

stress. 20% of GPs report finding practice “very stressful” (Commonwealth Fund).

National context

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• Pay: Public sector pay caps imply an erosion of living standards for many in the sector. In the care sector, the introduction of the

National Living Wage may present a challenge adversely affecting employment growth and leave employers struggling to meet

the demands from an ageing population. Alternatively, increased wage regulation may encourage companies to invest in new

technologies to improve productivity.

• Demand: The UK population is expected to grow to 71 million, a 10% increase, by 2029. In that time the population over 85 will

grow by 3.6 million. By mid 2039, more than 1 in 12 of the population is projected to be 80 or over. (HEE)

• Supply: More women are entering the workforce - and the overall workforce is getting older. Both are likely linked to a growth in

part-time work. Staff in training want a better work/life balance and want more time to care for patients.

• Ageing workforce: As well as an ageing population, the HSC workforce itself is also getting older. In 1996, just over a fifth of

nurses in the NHS were aged 50 or over; by 2015 the figure was estimated to be 37%. As the workforce gets older, and more

nurses retire, there is a significant risk of loss of knowledge, skills and experience (Christie and Co - Market Insight Report

(2015): The UK Nursing Workforce – Crisis or Opportunity?)

• Technology, genomics and research: Technology is growing rapidly, and people are taking up the opportunity that this offers.

This will provide an increased opportunity to predict disease, greater connectivity, different models of operation and an increased

ability to cure ill health.

• Patient and citizen personal choice: People will demand more personal choice as the ‘wellness agenda’ gathers pace.

Information will make people more aware, and less tolerant of, variations in service. Some perceive a trend from ‘grateful

citizens’ to ‘active consumers’.

• Service redesign: Service models are changing. There is greater demand for community provision and greater need for

specialised centres. Mental health services are being challenged to change too.

• Social/political: Social and political issues may be challenging concepts of individual and collective responsibility. Pooled

funding implies pooled responsibility – but people differ in the risks they run and the choices they make. How tolerant do

societies wish to be of such tensions?

• Finances: In 2015, the NHS accounted for 9.8% of GDP. Expected growth in required spend suggests increases of 6.2% in the

short term, higher in the medium and long term.

National Context (cont.)

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• Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

between the Treasury and GM paved the way for the councils and NHS in GM to take control of the region’s £6bn health and

social care budget. A range of changes are to be implemented that will enable healthcare to be more joined up. The programme

is based around 5 themes: radical upgrade in population health and prevention; transforming community based care & support;

standardising acute and specialist services to the best evidence; standardising back office and support functions; and enabling

better care.

• Reform: Activities in GM will include the reconfiguration of primary care and consolidation of secondary care; creating new

opportunities to integrate care across public private and voluntary sectors; and presenting new opportunities for organisations

who can deliver the new model and way of working.

• GM Health challenges: However, GM is also an area with very significant health challenges. The five year strategic vision,

‘Taking Charge of our Health and Social Care in GM’ highlighted that the high prevalence of long-term conditions such as

cardiovascular and respiratory disease mean GM people not only have a shorter life expectancy, but can expect to experience

poor health at a younger age than in most other parts of the country. Many areas within GM suffer from multiple deprivations,

where HSC services are particularly needed. Equally, many residents have complex medical and care requirements covering

multifaceted mental and physical health problems, long-term unemployment and wider social and financial issues. As GM’s

population is ageing, more people have developed multiple long-term conditions and the focus of healthcare has shifted from

curing illnesses to helping people live with chronic ill health.

• Health service in GM: The health sector is the third largest employment sector in GM (about 98,000 staff in 2015). GM is also

home to several nationally and internationally renowned teaching hospitals and research establishments.

• Northern Powerhouse: The Northern Powerhouse Independent Economic Review has identified specialisms in Health

Innovation (including Pharmaceuticals) in GM as well as Cheshire and Warrington, Hull and Humber, and the North East.

• Innovation: Future growth in relation to research and development and health innovation is likely to take place around the

existing and emerging clusters of health-related research and innovation. The area from Corridor Manchester, MediPark

(including University Hospital of South Manchester NHS Foundation Trust in Wythenshawe), potentially delivering around 4,500

new jobs and 250,000 sq. m. of new floor-space., through to key sites located just outside GM within Alderley Park and through

health data at Sci-tech Daresbury will be the major focus of activity.

GM context

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WORKFORCE OVERVIEW

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• .

Workforce Overview: Section Summary

• About 177,000 people work in the HSC labour market, according to the Greater Manchester Forecasting Model (GMFM).

Manchester is the district with largest number of staff (47,000). However, as a share of the local labour market the HSC sector

accounts for the largest proportions in Bury and Oldham (18.8% of all employment in Oldham and 16.8% in Bury).

• The HSC labour market has witnessed substantial expansion. Between 1991 and 2015, total employment in HSC grew by 46%

(or well over 50,000 jobs) compared with 10% in the GM labour market overall. Manchester accounted for over 20,000 of these

new jobs.

• About one in 10 people in HSC are self-employed – a slightly lower rate than the overall economy. However, HSC has a high

rate of part-time working. In the labour force as a whole about a quarter of workers are part-time, but in HSC, 38% are part-time

– and in care and social work rates are as high as 45%.

• About 104,600 people work in health-related employment. About 31,000 work in residential care and about 41,000 are employed

in social work.

• Employment is shaped at least in part by the pattern of hospital provision. Hospitals account for about 41% of people working in

the HSC sector.

• Rates of part-time working are much higher in the HSC sector than in the economy overall. About 38% of staff are part-time

compared with about a quarter elsewhere in the GM economy.

• Although Manchester has experienced the highest overall growth in job numbers, as a proportion of its labour force Oldham has

seen the most growth.

• There is evidence of the ageing workforce evident within the GM HSC sector. For example, not far off half of the staff working in

residential care are aged over 50 – much higher than in the UK overall. The prospect of increased retirements in the coming

years could exacerbate already existing problems with recruitment into care roles.

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GM’s health and social care sector accounts for about 177,000 jobs

14.2 12.2

43.5

13.38.3

13.916.2

10.1 10.114.7

2.12.0

3.8

2.0

1.3

1.52.4

1.8 1.1

2.4

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

50.0

Tota

l em

plo

ymen

t in

HSC

(0

00

s)

Self-employed Employees

Source: GMFM, 2015 (workplace-based jobs, annual average)

• There were 177,000 jobs

in Health and Social Care

in GM in 2015

• H&SC workforce is

concentrated in

Manchester where over

47,000 of the jobs are

located

• Just over one in ten

people working in the

sector in GM are self-

employed – slightly lower

than the rate of self-

employment in the

population as a whole.

• In absolute terms,

Manchester has the

highest number of self-

employed H&SC workers

(3,800).

• Tameside, Bury and

Wigan have the highest

proportions of self-

employed workers

compared to the overall

H&SC workforce.

Figure 1: Health and Social Care Employment, 2015

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Bury’s HSC sector accounts for a little under a fifth of all jobs

13.7%

18.8%

12.4%

16.8%

11.8% 11.7%

13.3%

15.3%

7.0%

14.3%

12.8%

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

16.0%

18.0%

20.0%

• Even though

Manchester has by far

the highest number of

HSC workers, as a

proportion of the total

workforce, HSC is

highest in Bury (18.8%),

Oldham (16.8%) and

Tameside (15.3%).

• These areas are likely to

depend most on the

sector to provide

employment for local

residents and could

suffer disproportionately

from any cuts to jobs.

• In contrast, the share of

HSC workforce is

markedly smaller in

Trafford than in any of

the other districts.

Source: GMFM

Figure 2: Share of HSC employment as a proportion of total employment

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Main employment clusters relate to sites of major hospitals

• Key employment clusters

relate mostly to the location

of major hospitals in GM

including: Royal Albert

Edward Infirmary and

Thomas Linacre Outpatient

Centre in Wigan, Royal

Bolton Hospital, Prestwich

Hospital, Royal Oldham

Hospital, Tameside General

Hospital, Stepping Hill

Hospital, Wythenshawe

Hospital, Christie Hospital,

Central Manchester

University Hospitals, Royal

Salford Hospital and North

Manchester General

Hospital.

• Significant concentrations of

employment can also be

found around the town

centres, including

Manchester city centre,

Wigan, Bolton, Bury,

Rochdale, Oldham, Ashton-

under-Lyne, Stockport and

Altrincham.

Figure 3: Main employment clusters of HSC workforce

Source: Business Register and Employment Survey | 14

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Share of residential care highest in Bury; social work in Trafford and Rochdale

9.9

5.9

33.7

8.9

4.2

8.9

11.5

6.5

4.8

10.3

104.6

2.5

5.5

5.6

2.5

2.3

2.2

3.4

2.0

2.3

3.0

31.3

4.0

2.8

8.0

4.0

3.1

4.1

3.7

3.3

4.1

3.9

41.0

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Bolton

Bury

Manchester

Oldham

Rochdale

Salford

Stockport

Tameside

Trafford

Wigan

GM

Human health activities Residential care activities Social work activities

• Human Health is the largest

sub-sector in the H&SC

sector in each district,

accounting for 60% of the

workforce in GM overall,

followed by Social Work

(23%) and Residential Care

(17%)

• Bury has the second largest

number of residential care

jobs (5,500) which accounts

for nearly 40% of the H&SC

workforce in the district; this

may reflect higher levels of

demand due to a larger than

average proportion of elderly

population

• For details of activities in

each of the three sub-sectors,

see Sections 86-88 of the

ONS SIC Code Guide (2017):

https://www.ons.gov.uk/meth

odology/classificationsandsta

ndards/ukstandardindustrialcl

assificationofeconomicactiviti

es/uksic2007

Source: GMFM, 2015

Figure 4: Employment in HSC sub-sectors, 2015

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Hospitals account for about 40% of HSC jobs

• Unsurprisingly,

hospitals are major

employment sites,

accounting for 41% of

all people working in

the sector.

• Together the three

health related sub-

sectors in HSC

(denoted by the SIC

code ’86’) account for

60% of staff.

• Approximately 40%

work in assorted

branches of care work.

• Just under a fifth (19%)

of the care workforce

work in residential care.

• Non-residential care

work accounts for

about 22%.

• A district breakdown of

this chart is available in

the final section of this

report.

Source: ONS BRES, 2015

Notes: Data refers to employed staff only (self-employment is excluded)

Figure 5: HSC labour force by subsector, 2015

66,380

14,14016,120

7,3604,420

10,7007,990

9,730

25,800

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

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66.8%53.8%

63.7% 60.4%

74.1%

54.1% 56.5% 55.0% 58.9% 62.0%

33.2%46.2%

36.3% 39.6%

25.9%

45.9% 43.5% 45.0% 41.1% 38.0%

full time Part time

Almost 40% of the HSC workforce is part time – rates especially high in care

• There is a much higher

rate of part-time

working in the HSC

workforce than applies

to the workforce at

large.

• Some 38% of the HSC

workforce is part time,

compared with about a

quarter of the whole

workforce.

• Residential work and

social work are much

more likely to support

part-time employment

(45% for social work

with the elderly and

disabled( and 46% for

care for the elderly.

• That said, health

related work is also

relatively high.

Source: ONS BRES, 2015

Figure 6: Split between full-time and part-time work, 2015

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Jobs in the HSC sector have grown by 46% between 1991 and 2015

Source: GMFM, 2016

Note: Employment is the total of Employees and Self-employed

• Between 2000 and

2015, the HSC sector

added more than

50,000 people to its

total labour force.

• The rate of

employment growth in

the H&SC sector has

eclipsed the rate of

employment growth in

GM’s labour market

overall.

• There has been 46%

growth between 1991

and 2015 in the HSC

workforce, compared

with growth of about

10% in employment

overall.

• The rate of growth in

self-employment has

been even more rapid

– 77% - over the same

period.

177,000

0

20

40

60

80

100

120

140

160

180

200

00

0’s

Total Employment - HSC Total Employees - HSC Self-employment - HSC

Figure 7: Employment change, 1991-2015

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0

5

10

15

20

25

30

35

40

45

501

99

1

19

92

19

93

19

94

19

95

19

96

19

97

19

98

19

99

20

00

20

01

20

02

20

03

20

04

20

05

20

06

20

07

20

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09

20

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20

11

20

12

20

13

20

14

20

15

Bolton

Bury

Manchester

Oldham

Rochdale

Salford

Stockport

Tameside

Trafford

Wigan

Employment growth highest in Manchester

• There has been a

positive growth trend

in levels of H&SC

employment in GM

over the last 2

decades, with an

increase of over a

third (nearly 50,000

jobs) between 1995

and 2015

• Most of this

employment growth

has been

concentrated in

Manchester, which

gained 20,000

additional jobs in

H&SC over the same

period

Source: GMFM

Figure 8: Employment forecasts by district, 1991-2015

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Oldham, Manchester, Bolton, Wigan have seen greatest relative jobs growth

0

50

100

150

200

250

19

95

19

96

19

97

19

98

19

99

20

00

20

01

20

02

20

03

20

04

20

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15

Bolton BuryManchester OldhamRochdale SalfordStockport TamesideTrafford WiganGreater Manchester H&SC Greater Manchester Total Economy

• Using 1995 as a reference point,

Oldham, Manchester, Bolton and

Wigan have seen the greatest

increases in the size of their H&SC

workforce, above the level of growth

seen in the sector across GM as a

whole

• Meanwhile, H&SC employment

levels in Salford and Rochdale have

been the most stable over this

period, changing very little between

the late 90’s and 2015

• Similar trends can be seen more

recently (between 2005 and 2015) as

well, with most districts seeing

growth, except Salford, where

employment remained flat, and

Rochdale, where it declined a little

Source: GMFM

Figure 9: Change in HSC employment (index 1995=100)

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More than half of residential care workers are aged over 50

• The table shows the age

profile in GM’s HSC sub-

sectors.

• Some occupational sub-

sectors of the HSC labour

market appear to

demonstrate the issue of

an ageing workforce; for

example, not far off half of

the staff in residential care

are aged over 50 – a rate

that is significantly above

national average levels.

• In human health and

residential care the

proportion of staff aged

under 30 is lower than

national norms.

• Social work without

accommodation is one of

the few areas with GM’s

share of younger workers

(<30) is higher than the

UK average – 24.8% in

GM compared with 22.4%

in the UK.

Source: ONS Annual Population Survey

Figure 10: Age profile of HSC workforce in UK and GM

United Kingdom Greater Manchester

Age group86 Human

health activities

87 Residential

care activities

88 Social work

without

accommodation

86 Human

health activities

87 Residential

care activities

88 Social work

without

accommodation

16 to 24 7.1% 11.8% 11.9% 6.6% 5.1% 16.2%

25 to 30 10.5% 11.2% 10.5% 8.0% 14.5% 8.6%

30 to 39 22.6% 18.1% 21.3% 28.8% 13.4% 16.9%

40 to 49 25.8% 22.6% 22.0% 25.8% 19.9% 28.1%

50 to 64 30.7% 32.2% 30.3% 30.2% 38.6% 30.2%

64 and above 3.3% 4.1% 4.0% 0.6% 8.5% 0.0%

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Page 22: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

LABOUR FORECASTS

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Page 23: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

HSC labour forecasts: section summary

• This section uses the Greater Manchester Forecasting Model produced for GMCA by Oxford Economics to understand

anticipated future labour market trends. As with all forecasts the information needs to be understood as a likely indication of

future change, based on the available information and ‘reasonable’ assumptions about the future, rather than as an exact

quantification. Forecasts always come with caveats. For further information on the GMFM, please see

http://www.neweconomymanchester.com/publications/greater-manchester-forecasting-model

• The HSC sector is forecast to grow in the years to 2035. Under a ‘baseline’ forecast, the sector will add about 17,000 jobs to

employ about 193,600 people by 2035. Under the ‘accelerated growth scenario’ – a forecast underpinned by more optimistic

assumptions about population and economic growth – it will employ 24,000 more people in 2035, to take total HSC employment

to over 20,000.

• Health related roles in nursing, midwifery, medical professions and related occupations account for the bulk of the job growth –

together adding up to about 20,000. Care is another significant growth area (accounting for about 8,800). Some occupational

areas are expected to reduce their job numbers including administration roles, management and elementary roles, such as

security and hospital portering.

• However, most of the sector’s need for labour will not come from expansion. The vast majority is ‘replacement demand’ –

meaning job churn caused by retirements, job moves, migration, unemployment and so on. Combining ‘expansion demand’ and

‘replacement demand’ gives the HSC’s ‘net labour requirement each year’. This will be in the order of between 16,000 and

18,000 jobs each year that need to be filled. In total, this amounts to more than 350,000 jobs in the years to 2035.

• The prominence of care roles in replacement demand is especially apparent. Between 8,000-9,000 care jobs a year need to be

filled in GM.

• The pattern of future job need is shaped by existing patterns of employment. Manchester is the district with the largest need for

staff – in the order of about 4,400 a year on average. Other districts with substantial requirements include Salford (2,900), Wigan

(1,600), Oldham (1,600), Bury (1,200) and Stockport (1,200).

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Page 24: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

Between 17,000 and 24,000 jobs are expected to be added by 2035

• GMCA uses two forecasts in

order to understand likely

labour supply. One is the

‘baseline’ forecast derived from

the best available current

information and the second

applies higher assumptions

about population and economic

growth; this is known as the

‘accelerated growth scenario’

or AGS for short.

• The chart shows the two

scenarios. Under the baseline

forecast, the labour force

working in health and social

care will rise from 176,600

people in 2015 up to 193,600

by 2035. Thus GM is expected

to increase its HSC workforce

by a little under 17,000 people.

• Under the AGS the HSC sector

will increase its total labour

force by over 24,000 people. It

will account for over 200,000

jobs by 2035 under this

scenario.

Source: GMFM 2015

Figure 11: Forecast total employment in HSC in GM, 2005-2035

193.6

200.8

120.0

140.0

160.0

180.0

200.0

220.0

Tota

l Em

plo

yme

nt

Each

Ye

ar (

exp

ansi

on

de

man

d)

BASELINE AGS2015

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Page 25: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

Health professions and care drive forecast growth

• The occupations likely to

grow fastest under the

AGS are in the clinical

health occupations which

are expected to account for

the vast majority of the

overall job growth.

• However, caring and other

service occupations are

also likely to add

approximately 900 new

jobs.

• Occupational areas that

are projected to shrink

include administrative and

secretarial occupations,

elementary jobs such as

hotel porters and security

as well as HSC

management jobs.

Source: New Economy Analysis using GMFM AGS and ONS Annual Population Survey Workforce data

Figure 12: HSC occupational forecasts, 2015-2035

Occupation area Projected growth 2015 - 2035

Managers, Directors and Senior Health Officials -1,000

Health Professional Occupations

(e.g. Nurses, Mid-wives, Psychologists, Pharmacists, Medical radiographers, Ophthalmics etc.)+20,800

Health and Social Welfare - Health Associate Professional & Technical Occupations

(e.g. Paramedics, Pharmaceutical technicians, Medical and dental technicians etc.)+5,100

Administrative and Secretarial Occupations

(e.g. Medical secretaries, Clerks and Assistants, Human resources administrative occupations etc.)-7,800

Skilled Trades Occupations

(e.g. Building repair and maintenance etc.)0

Caring and Other Service Occupations

(e.g. Nursing auxiliaries and assistants, Senior care workers, Care workers and home carers)8,800

Sales and Customer Service Occupations

(e.g. Customer service managers and supervisors, contact centre occupations)2,000

Process, Plant and Machine Operatives

(e.g. Routine inspectors and testers, Other general machine operatives, drivers n.e.c.)-1,000

Elementary occupations

(e.g. Hospital porters, Elementary administration, security, cleaning occupations etc.)-2,600

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Page 26: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

Almost 17,000 staff needed each year in HSC

• As well as jobs prompted by growth

in the sector most labour demand

is caused by ‘churn’ – people

retiring, moving jobs, migrating,

being made redundant and so on.

This is known as ‘replacement

demand’, as opposed to ‘expansion

demand’ arising from growth.

• Once expansion demand and

replacement demand are combined

we can examine the ‘net

requirement’ within the HSC sector.

• GM’s net requirement in HSC is

between 16,000 and 18,000 –

averaging at about 16,800 a year.

• Each year the part of the HSC

labour force that needs to recruit

hardest is social care, requiring

between 8,000 and 9,000 staff a

year. This is almost certainly

caused by high turnover within the

sector, but may also reflect an

ageing workforce.

Source: GMFM

Figure 13: Forecast demand each year in HSC (net requirement) in GM, 2005-2035

0.0

1.0

2.0

3.0

4.0

5.0

6.0

7.0

8.0

9.0

10.0

2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035

Tota

l net

req

uir

emen

t fo

r la

bo

ur

each

yea

r (0

00

s)

22 Health Professionals 32 Health and Social Welfare Associate Professionals 61 Caring Personal Service Occupations

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Page 27: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

Total future requirement for HSC workers in GM is about 16,800 a year

• The total future requirement

for HSC workers in GM

(equal to expansion demand

plus replacement demand) is

just under 17,000 workers on

average per annum up to

2035, amounting to 353,000

jobs in total.

• Manchester and Salford are

predicted to need the highest

numbers of workers over the

next two decades, while the

requirement will be smallest

in Trafford and Rochdale,

roughly in line with the

current distribution of HSC

workers in GM.

• According to forecasts, the

total labour requirement per

annum in GM is predicted to

rise from 2018, peaking at

over 18,000 in 2022, before

levelling off to around 16,000

per annum between 2025

and 2035.

Source: GMFM, 2015

Total requirement

2015-2020 (000s) 2015-2035 (000s)

Total Average p.a. Total Average p.a.

Bolton 8.3 1.4 29.6 1.4

Bury 7.4 1.2 25.6 1.2

Manchester 23.8 4 91.6 4.4

Oldham 9.3 1.6 33.7 1.6

Rochdale 6 1 19.8 0.9

Salford 16.6 2.8 61.9 2.9

Stockport 7.8 1.3 25.1 1.2

Tameside 6.7 1.1 21.3 1

Trafford 3.9 0.6 11.5 0.5

Wigan 11 1.8 33 1.6

GM 101 16.8 353 16.8

Figure 14: Net requirement for HSC employees by district, 2015-2035

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Page 28: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

VACANCIES

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Page 29: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

Vacancies: section summary

• This section uses data supplied by Labour Insight, an online database of job adverts, to provide insight on current vacancies.

• Labour Insight purports to capture all online job adverts issued between January and July 2017. The information is supplied to

provide an indication of likely recruitment patterns relevant of the HSC sector. Labour Insight informs other LMI studies used by

GMCA. However, the data may not match exactly with other vacancy databases used within the health and social care system

and it is possible that some of the adverts were duplicates – in other words, re-advertised positions. As a result it should be

treated as an indication regarding immediate labour demand (or in the recent past) rather than as fully validated statistics.

• Nurses were by far the more sought-after staff, registering 4,600 adverts out of a total of 17,700 HSC relevant positions.

• Care workers and home carers were sought in over 2000 adverts.

• Other types of worker in demand included social workers, associate professionals in health and medical practitioners.

• Some 30% of the positions demanded a degree. 178 adverts (6%) required post graduate qualifications.

• Skills involved in working in mental health services emerge strongly from the data about job vacancies. Some 1,600 adverts

specified mental health skills – more than involved in ‘patient care’ or ‘care planning’.

• The NHS was responsible for issuing some 43% of the adverts in the HSC sector between January and July 2017.

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Page 30: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

17,700 jobs were advertised within the HSC sector in GM in 2017 (ytd)

• Labour Insight is an online

database of vacancy

information. It only captures job

adverts posted online.

• Data between January 1 and

July 11th 2017 suggests there

were 17,700 jobs advertised in

HSC.

• Most common were nursing

related adverts (over 4,600).

Care workers (2000), care

managers (555) and senior

care workers (311) also figured

prominently in the list.

• Caveats: The chart does not

cover all adverts – only the

most common. It is also

possible that some positions

may be duplicates – i.e. the

same position re-advertised.

Posts may also be withdrawn.

Numbers should be treated as

indicative of demand.

Source: Labour Insight

4,6372,011

878

736

556

555398

329

325

311

299223

215

200187

186

161153

145

137

137

129

124

122118

0 500 1,000 1,500 2,000 2,500 3,000 3,500 4,000 4,500 5,000

Nurses (2231)

Care workers and home carers (6145)

Medical practitioners (2211)

Health associate professionals n.e.c. (3219)

Social workers (2442)Residential, day and domiciliary care managers and…

Other administrative occupations n.e.c. (4159)

Nursery nurses and assistants (6121)

Physiotherapists (2221)

Senior care workers (6146)

Nursing auxiliaries and assistants (6141)Health services and public health managers and directors…

Human resources and industrial relations officers (3562)

Beauticians and related occupations (6222)

Receptionists (4216)

Occupational therapists (2222)Company secretaries (4214)

Dental nurses (6143)

Office supervisors (4162)

IT user support technicians (3132)

Records clerks and assistants (4131)

Biological scientists and biochemists (2112)

Psychologists (2212)

Medical radiographers (2217)Health professionals n.e.c. (2219)

Figure 15: Top vacancies in GM for HSC workforce jobs, Jan-July 2017

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Page 31: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

About 30% of adverts require at least a degree

• Of the adverts that

specified a qualification

level (14,700) of the

17,715 HSC related

adverts, 36% required at

least GCSE level

education – a level 2 in

terms of skills level.

• 30% required either a

BA/BSC degree or a

diploma.

• Level 3 qualifications –

typically at least 2 A

levels – were needed in

22% of the adverts.

Source: Labour Insight

36%

30%

22%

6%4%1%1%

GCSEs, Standard Grades, and Level 2 S/NVQs

Bachelor's degrees, graduate certificates and diplomas

A-Levels, Highers, and Level 3 S/NVQs

Post graduate degrees, Level 5 S/NVQs, certificates, and diplomas

Level 4 diplomas and certificates, HNCs, Level 4 S/NVQs

Foundation degrees and HNDs

Level 1 S/NVQs

Figure 16: Distribution of skill level in job adverts in HSC in GM, Jan-July 2017

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Page 32: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

Mental health tops the list of skills sought by HSC employers

• In terms of the specific skills

that advertisers seek from

candidates in the HSC

sector, mental health

emerges very strongly.

Almost 1,600 jobs sought

people with mental health

skills.

• As expected, other skills

cover the remit of HSC work

– from Microsoft packages

to therapy to customer

service to cleaning.

Source: Labour Insight

1,5781,035

1,022875

825660

615546

482461

441399388382371370362359

330317307306

286281272

0 200 400 600 800 1,000 1,200 1,400 1,600 1,800

Mental Health

Care Planning

Caregiving

Home Management

Customer Service

Microsoft Excel

Microsoft Office

Microsoft Windows

Therapy

Business Management

Elder Care

Administration Management

Medication Administration

Figure 17: Skills sought by employers within GM labour market, 2017

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Page 33: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

Communication skills are most common need of recruiting employers

• Communication,

organisation,

collaboration and

planning skills

were the most

common types of

skills sought by

employers in the

sector.

Source: Labour Insight

3,876

2,684

894

855

747

638

549

541

477

414

413

407

375

327

321

321

222

221

219

216

200

197

186

179

150

0 500 1,000 1,500 2,000 2,500 3,000 3,500 4,000 4,500

Communication Skills

Organisational Skills

Team Work/ Collaboration

Planning

Leadership

Writing

Quality Assurance and Control

Research

Creativity

Mathematics

Detail-Orientated

English

Typing

Time Management

Computer Skills

Problem Solving

Mentoring

Prioritising Tasks

Decision Making

Meeting Deadlines

Positive Disposition

Presentation Skills

Management

Staff Coordination

File Management

Figure 18: Top skills sought by employers, Jan-July 2017

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Page 34: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

NHS responsible for over 5,500 job adverts so far in 2017

• 7,700 of the 17,715

total job adverts

specified the

employer.

• As might be expected

the NHS dominates

recruitment in the

sector.

• Charities and care

homes are also

significant recruiting

presences in the GM

HSC labour market.

Source: Labour Insight

5,575

328

172

129

110

106

96

85

78

62

54

46

42

39

38

36

35

31

29

29

27

26

25

25

25

0 1,000 2,000 3,000 4,000 5,000 6,000

NATIONAL HEALTH SERVICE

CREATIVE SUPPORT

HC-ONE

ATTB

YOUR WORLD NURSING

BMI HEALTHCARE

CARE COM LIMITED

JANE LEWIS HEALTHCARE

LOCAL CARE FORCE

PRIORY GROUP

BARCHESTER HEALTHCARE

NEWCROSS HEALTHCARE

HAMILTON CROSS

SPIRE HEALTHCARE

SYNF

247 PROFESSIONAL HEALTH

MENCAP

HOMECARE GROUP LIMITED

CAMBIAN GROUP

TTR NUFFIELD

MHA

PULSE NURSING REGIONS

FLAMEHEALTH

RIG HEALTHCARE

TTR 4LEISURE

Figure 19: Top employers advertising jobs in GM Jan-July 2017

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Page 35: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

SPECIALIST STAFFING AREAS

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Page 36: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

• The slides in the following section draw on Unify data and forecasts from GMFM. Unify is the NHS online data collection system

for data collating, sharing and reporting. It is an invaluable data source regarding NHS providers, but because the health and

social care system is much wider than the NHS other sources are needed to supplement the information it provides. Here, we

use Unify data to anticipate jobs between 2017 and 2021. GMFM data provides the annual expansion and replacement

information, based on longer term forecasts (to 2035).

• The workforce across Greater Manchester consists of eight broad categories, as detailed below. In the case of social care, we

have supplemented Unify information with data from Skills for Care based on projections of the growth of the population aged

over 65 and 75.

• Nursing: We anticipate replacement demand in the order of 1,200 a year.

• Medical staff: More than 300 additional consultants will be required each year.

• Social care staff: Over a third of HSC staff work in social care. As the largest staff group, replacement demand of over 6,500

care staff and 2,000 managers, professionals and others will be needed each year. Social care is the area where there is likely

to be significant growth in jobs (as opposed to replacement of existing staff through churn and retirements). Projections from

Skills for Care based on the population of GM aged over 75 suggest the social care workforce may need to expand from about

66,000 today to 94,000 by 2030.

• AHPs: About 450 staff a year will be needed.

• In children's services, vacancy rates are not especially high : Vacancy rates are not high. An additional 19 consultants, 18 other

doctors and 118 Paediatric nurses will be required.

• Radiologists and Radiographers: About 130 are likely to be needed each year.

• Acute medical staff: current data shows 7% vacancy rate. About 30 doctors are needed each year.

• Mental health staffing: Mental health vacancies are predominantly in nursing and are running at 40%. Replacement demand will

require more than 250 staff.

Specialist Staffing Areas: Section Summary

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Page 37: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

There are eight categories of HSC jobs

• The workforce across

Greater Manchester

consists of eight broad

categories They are:

• Nursing.

• Medical staff.

• Social care staff

• Allied Health

Professionals (AHPs)

• Specific elements

including:

• Children's services

• Radiologists and

Radiographers

• Acute Medical staff

• Mental health staffing

1%

34%

9%

17%

13%

11%

10%

5%

Ambulance Staff Direct Social Care HCA and Support Staff Managers and Admin

Nursing and Midwifery Other Roles Scientific and Professional Medical and Dental

Source: Unify data

Figure 20: Breakdown of NHS specialist areas, 2016

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Page 38: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

• GMFM implies that about

1,200 nurses, about 550

doctors and about 420

allied health professionals

will be needed each year.

This represents the health

sub-sector’s total new

requirement.

• The nursing figure in

particular represents a

substantial requirement.

• It is worth noting that in

health the expansion

demand is relatively

modest or even declining

in some areas (e.g. Allied

health professionals) –

reflecting a sector that is

not anticipated to grow

significantly.

• The second table focuses

on specialist areas with

widely recognised labour

market challenges.

Staff Type Current staff Vacancies Vacancies (%) 2017 2018 2019 2020 2021 Expansion (pa) Replacement (pa) Total annual demand

Nurses (elderly, acute and general) 111081 834 8 11915 11996 1184 11761 11731 -46 1274 1229

All Consultants 2717 183 7 2901 2945 2978 2975 2968 17 310 327

All other doctors* 1949 -29 -1 1920 2041 2030 2018 2009 22 205 228

Total all doctors 4666 154 3 4820 4986 5007 4992 4977 39 516 555

Allied Health Professionals 4151 142 3 4293 4259 4196 4186 4155 -34 459 425

About 1,200 nurses needed each year

Sources: Figures on current staff, vacancies and five year forecast are taken from Unify data; Expansion and replacement calculations are taken from

GMFM forecasts.

Notes: Other doctors excludes F1/F2 trainees

Figure 21: Forecast demand for specialist medical staff

Staff Type Current staff Vacancies Vacancies (%) 2017 2018 2019 2020 2021 Expansion (pa) Replacement (pa) Total annual demand

Mental health

Child and Adolescent Psychiatry Consultant 20 0 2 21 39 39 39 39 5 2 7

Forensic Psychiatry Consultant 11 1 10 12 12 12 12 12 0 1 1

General Psychiatry Consultant 120 116 97 236 130 130 130 128 -27 25 -2

Learning Disabilities (LD nurses) 75 2 2 77 77 77 79 79 1 8 9

Medical psychotherapy Consultant 0 0 0 0 0 0 0 0 0 0 0

Old Age Psychiatry 14 3 19 16 32 32 32 32 4 2 6

Other doctors* 243 -109 -45 135 239 228 224 224 22 14 37

Psychiatry (MH Nurses) 1370 538 39 1909 1948 1945 1929 1914 1 204 205

Psychiatry (learning disability) 0 0 0 0 2 2 2 2 1 0 1

Psychotherappy 35 24 69 59 59 59 59 59 0 6 6

Total 1888 576 31 2464 2506 2524 2506 1489 6 264 270

Radiography and Radiology

Clinical Radiology Consultants 179 12 6 190 199 201 201 201 3 20 23

Radiography (Diagnostic) 882 32 4 914 919 896 894 891 -6 98 92

Radiography (Therapeutic) 130 1 1 131 135 136 140 142 3 14 17

Total 1191 44 4 1236 1253 1233 1235 1234 -1 132 132

Emergency Medicine

Emergency Medicine Consultants 104 2 2 106 115 115 116 116 3 11 14

Other doctors* 146 14 9 160 154 154 153 152 -2 17 15

Total 250 16 6 266 269 269 268 268 1 28 29

Childrens

Paediatrics Consultants 179 4 2 182 182 181 181 180 0 19 19

Paediatric Cardiology Consultants 6 0 0 6 6 6 6 6 0 1 1

Other doctors (excl F1/F2 trainees) 164 3 2 167 169 169 168 167 0 18 18

Paediatric Nursing 1030 13 1 1043 1072 1072 1070 1067 6 112 118

School Nurses 289 11 4 300 292 292 288 285 -4 32 28

Total 1669 31 2 1699 1720 1720 1713 1706 2 182 183

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Page 39: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

• In 2017, GM’s adult

social care workforce

employed

approximately 65,200

people.

• Most of the workforce

work in care, but

professional and

managerial staff

number about 10,000.

• Manchester is the

district with the largest

ASC workforce,

followed by Wigan.

Care sector needs about 8,700 a year

Sources: Figures regarding NHS staff are supplied by NHS direct; figures regarding direct payment

recipients are estimates using regional totals supplied by NHS Digital

Figure 22: Adult social care workforce numbers and forecast

Role 2017 2018 2019 2020 2021

Annual

expansion

Demand

Annual

replacement

Demand

Total

Annual

Demand

Direct care 50274 51507 52503 53577 55495 1305 5377 6683

Managers 4803 4918 5012 5114 5297 124 514 637

Professional 2759 2827 2885 2943 3053 74 295 369

Other 7404 7587 7738 7901 8191 197 792 989

Grand Total 65239 66840 68138 69536 72036 1699 6978 8677

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Page 40: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

• This chart uses population

data to model the effects

of an ageing population on

the ASC workforce.

• Projections based on the

population of 65+ year

olds in the GM population

imply a need for

approximately 87,000

workers in ASC by 2030.

• If using projections of the

population of 75+ year

olds, the total likely to be

needed rises by nearly

94,000.

Figure 23: Social Care: jobs forecast to 2030

Source: Figures supplied by Skills for Care

Social care workforce likely to rise to at least 90,000

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Page 41: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

SKILLS SUPPLY AND

APPRENTICESHIPS

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Page 42: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

• How the skills formation system operates is a critical part of the answer to how staff and skill shortages in GM can be met. This

section examines the flow of skills – or at least qualifications - into the HSC labour market from data supplied by learning

providers. Other information from, for example, NHS digital regarding training places and commissions is also available.

• HSC is a relatively diverse labour market, with some roles being highly regulated and with strict qualification protocols attached

to the work (for example, clinicians). However, the British labour market as a whole is notable for having very low ‘licence to

practice’ arrangements in place in many occupations as part of the emphasis on workforce flexibility. This means that in many

roles there is not always a set, pre-determined path of skill acquisition: workers with assorted qualifications can often move

relatively freely between sectors; this may be relevant to many relatively low skill (e.g. Care assistants) and other support roles

(e.g. IT support) within the healthcare labour market. Given this flexibility, there can never be a perfect match between skills

supply and labour demand across all areas of the workforce.

• In what follows, we explore three sorts of post-16 learning: apprenticeships, further education and university courses.

• In total, GM has about 17,000 studying relevant subjects at University, about 10,000 apprentices and about 14,000 course starts

in HSC related courses. In further education and apprenticeships, social care accounts for the great majority of these courses. In

University, health professions drive most of the learning.

• As well as the need to develop new staff, there are also skills gaps within the existing workforce. Skills for Health identifies skill

gaps in the workforce, including: problem solving, oral communication, customer handling, teamwork and management and

leadership skills. The implications of changes to health and care service provision towards the ‘personalisation of care’ will result

in healthcare assistants needing to learn a wide range of skills and working practices to provide support that enables people to

remain independent.

• In addition the configuration of health and social care implies the need for new skillsets and potentially the need for increased

use of ICT.

Skills Supply and Apprenticeships: Section Summary

| 42

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Course Level2014-15 2015-16

Starts Achievements Starts Achievements

Health and Social Care

Level 2 2,453 1,183 2,341 1,281

Level 3 1,933 860 1,958 975

Total 4,386 2,043 4,299 2,256

Dental Nursing

Level 3 242 119 205 115

Total 242 119 205 115

Care Leadership and Management

Level 4 Plus 547 68 463 132

Total 547 68 463 132

Health Assistant Practitioner

Level 4 Plus 0 0 2 0

Total 0 0 2 0

Grand Total 10,350 4,460 9,936 5,006

Figure 24: Apprenticeships in health and social care by level, 2014/15-2015/16

• Approximately 10,000 people a

year begin an apprenticeship

relevant to the sector in GM.

• Health and social care is by far

the most significant type of

apprenticeship, accounting for

about 4,300 starts a year.

• Numbers fell during the two

academic years featured in the

table. HSC accounts for most of

the fall. However, dental nursing

and care leadership and

management also dipped.

• Fluctuations in apprenticeship

volumes are a relatively frequent

occurrence. More data than two

years is necessary before

analysing trends.

• Care leadership is significant in

that it dominates apprenticeship

provision across GM at level 4:

the sector appears to have

embraced apprenticeships as a

means of developing managers.

• ‘Achievements’ refer to

qualifications obtained in the

academic year – an achievement

is not a ‘success rate’.

Source: SFA Datacube 2015/16

About 10,000 people a year begin apprenticeships relevant to the sector in GM

| 43

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• GM’s public sector organisations have

been working together to identify joint

mechanisms and activity to add value to

the investment each organisation will

make individually through the

apprenticeship levy.

• The table provides an illustration of GM

NHS (Provider) organisations, with CCG

data to be added.

• The NHS organisations alone account for

approximately £11.8m of investment in

apprenticeships.

Trust Name Indicative Levy Payment 2017/18

Approx.Headcount

Indicative Public Sector Target 2.3%

May 2017 to March 2018

Forecast Apprenticeship

StartsBolton NHS FT £765,824 5,387 124 255

Central Manchester University Hospitals NHS FT

£2,334,000 12,708 292 311

Christie Hospital NHS FT £418,525 2,611 60 66

Pennine Acute Hospitals NHS Trust

£1,825,000 9,306 214 186*

Salford Royal NHS FT £1,098,500 6,966 160 187

Stockport NHS FT £859,316 5,730 132 155

Tameside & Glossop Integrated Care NHS FT

£504,000 3,500 81 84

University Hospital of South Manchester NHS FT

£1,022,912 6,072 140 160

Wrightington, Wigan and Leigh NHS FT

£885,000 5,015 120 96*

Greater Manchester Mental Health NHS FT

£673,659 4,753 109 252

Pennine Care NHS FT £860,019 5,800 133 130*

North West Ambulance Service

£589,899 6,312 145 34*

Apprenticeship levy implies £11.8m of investment from NHS alone

Figure 25: Indicative health sector apprenticeship levy

| 44

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Figure 26: Course starts and achievements in further education, 2014/15-2015/16 • Most of the courses studied in

further education colleges are

health and social care – about three

quarters of all courses starts are

HSC either at level 2 or level 3 (a

level 2 is roughly equivalent to

GCSEs, a level 3 to A levels).

• Starts in HSC have fallen by a third

in the two academic years shown in

the table. This is accounted for by

large drops at relatively low skill

level, such as entry and level 1 and

level 2.

• Starts in FE are generally falling,

especially at lower skill levels.

• A level 4 qualification is roughly

equivalent to the first year of a

standard bachelor’s degree.

• ‘Achievements’ refer to

qualifications obtained in the

academic year – an achievement is

not a ‘success rate’.

Source: SFA Datacube, 2015/16

About 14,400 people began college courses in HSC related subjects in 2015/16

Starts Achievements Starts Achievements

Health and Care 21,081 18,201 14,428 11,492

Medicine and Dentistry 190 121 185 117

Entry level/Level 1 5 3 2 2

Level 3 183 115 181 115

Level 5 1 2 2 0

Not Applicable/ Not Known 1 1 0 0

Nursing and Subjects and Vocations Allied to

Medicine811 532 781 557

Entry level/Level 1 2 9 104 104

Level 2 1 1 0 0

Level 3 773 505 660 436

Level 4 (original) 34 16 17 17

Not Applicable/ Not Known 1 1 0 0

Health and Social Care 20,080 17,548 13,462 10,818

Entry level/Level 1 3,718 3,284 2,051 1,600

Level 2 10,505 9,431 5,732 4,832

Level 3 5,374 4,526 4,913 3,891

Level 4 (original) 431 257 436 225

Level 5 (original) 2 1 0 0

Not Applicable/ Not Known 50 49 330 270

2014-2015 2015-2016Level

| 45

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Figure 27: Course starts by type of qualification in further education colleges, 2015/16• Certificates dominate

vocational provision in further

education colleges and

among training firms (more

than 3,800 a year were

started).

• However, in the clinical

disciplines, there is

significant provision of

access courses (more than

1,000). Unlike the vast

majority of courses at level 3

and above, access course

fees are written off provided

the student progresses to

higher education.

• BTEC qualifications in health

and social care amount to

more than 2,300 starts.

• Foundation degrees totalled

about 130 starts.

• NB: A learner can have more

than one ‘start’. Data on

learner counts is expected

soon.

Source: SFA Datacube, 2015/16

Vocational certificates in health and social care dominate provision in FE

133

660

429

1222

0

500

1000

1500

2000

2500

3000

3500

4000

4500

Medicine and Dentistry Nursing and Subjects Allied toMedicine

Health and Social Care Total

Access BSc (Hons) Diploma Certificate BTEC Foundation Degrees Award Non regulated provision

| 46

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About 17,200 people study HSC related subjects at GM universities

• Among clinical roles, about

3,400 doctors studied in GM in

2015/16 academic year – the

vast majority at the University

of Manchester.

• GM based HEIs supply 5.7%

of the UK total. About 75% are

undergraduates and a quarter

postgraduates.

• Among subjects allied to

medicine, GM HEIs have

about 13,800 people studying

these subjects. Within these

people, just under half are

nurses.

• Among subjects allied to

medicine about 63% are

undergraduate positions.

• We can assume a third of this

total qualify each year –

approximately 5,700 people a

year.

• Data can be broken out into

undergraduate and post-

graduate.

Subjects Allied to Medicine

Anatomy,

physiology &

pathology

Pharmacology,

toxicology &

pharmacy

Complementary

medicines,

therapies & well-

being Nutrition Ophthalmics

Aural &

oral

sciences Nursing

Medical

technolo

gy

Others in

subjects

allied to

medicine

Broadly-based

programmes within

subjects allied to

medicine

Total -

Subjects

Allied to

medicine

The University of Bolton 0 20 15 0 0 0 1095 5 275 0 1410

The Manchester Metropolitan University 630 0 10 250 0 200 1020 170 140 0 2420

The University of Manchester 605 1090 0 0 275 330 1885 55 380 0 4615

The University of Salford 630 0 0 0 0 0 2710 370 1670 0 5380

GM Total 1865 1110 25 250 275 530 6710 600 2465 0 13825

UK Total 20820 25725 3075 6570 3760 4005 153795 9100 57285 805 284935

Source: HESA 2015/16

Notes: the data refers to people who are studying the relevant subjects in the

reference year. Separate data is available on qualifiers by year.

Figure 28: Students (undergraduate and postgraduate) studying at GM HEIs (2015/16)

Medicine and Dentistry Pre-clinical medicine

Pre-clinical

dentistry Clinical medicine

Clinical

dentistry

Others in

medicine &

dentistry

Medicine &

dentistry total

The Manchester Metropolitan University 0 0 0 0 35 35

The University of Manchester 860 80 1720 440 275 3370

GM Total 860 80 1720 440 310 3405

UK Total 15160 1500 38040 6580 4260 65550

| 47

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Figure 29: Percentage of graduates from GM HEIs who find work in GM by subject, (2014/15 leavers)

• The Higher Education

Statistics Agency conducts

its destination’s survey six

months after graduation.

• In medicine and dentistry,

just over a third of the total

graduates from GM HEIs

choose to begin their career

in GM. This is towards the

lower end among the various

subject disciplines.

• However, graduates of

courses relevant to subjects

allied to medicine are far

more likely to settle in GM –

61% of them. This is at the

high end of the subject

disciplines and these

graduates are most likely to

stay in GM post graduation.

• If examining all who chooses

to settle in GM (irrespective

of whether they are in work

or pursuing another activity),

then a combined proportion

of 55% settle in GM from

medicine and dentistry and

subjects allied to medicine.

Source: HESA Destination of Leavers from Higher Education (DLHE) Survey, 2014/15

61% 61% 61%57% 56%

50% 50% 48%

44% 43% 42% 42% 41%

37%35% 34% 33%

28%

0%

10%

20%

30%

40%

50%

60%

70%

A third of medicine and dentistry graduates begin their careers in GM

| 48

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CARERS AND THE VOLUNTARY

WORKFORCE

| 49

Page 50: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

• As well as staff, freelances and contractors employed in the HSC labour market it is important to remember that the sector

also has considerable human capital involved in a voluntary capacity or as carers. These people may not sell their labour

as conventional employees do, but nevertheless it has considerable practical, social and indeed economic value.

• Voluntary sector: According to a 2017 study of the Voluntary, Community and Social Enterprise sector in GM there are

about 7,300 (46% of total) organisations involved in various capacities in providing health and care. Most of them are likely

to be very small with less than £10,000 turnover; 10% had more than 20 staff.

• Although we do not have a figure for how many people are employed specifically in health or care, in total the VCSO

sector had 42,600 people working in it in 2017 (28,600 FTE). There were also over 350,000 volunteers (again we do not

know how many work specifically in health).

• Of the VCSE organisations focussed on health, most stated they worked in ‘health and wellbeing in general’. Just over half

said they concentrated on mental health and about a third worked in ‘healthy living’ (food, lifestyle and sexual health).

• Carers: There are approximately 280,000 carers in GM (a rise of 9% in the last 10 years). This is just over 10% of the

population – just above the national average.

• GM carers provide more care than the population average: approximately 70,000 carers in GM provide over 50 hours of

care per week.

• GM carers are more likely to be younger than the population average. Furthermore, there are proportionally fewer carers in

work where they are aged between 16 and 64, which is significant given the higher volumes of younger carers

• The value of carers’ unpaid support across GM is worth £5.9 billion a year.

• GM has a slightly lower than average rate of carers juggling work and care compared with the national average for

England - 52% for GM compared with 53.1% for England. The ‘employment effect’ of caring (carers are less likely to be in

work) is thus amplified in GM. Carers are twice as likely to be in bad health compared with non-carers if they are providing

over 50 hours of care per week. In all councils (bar Stockport which is the same as the national average), all have a higher

proportion of carers in bad health. The national average is 13%; in GM the proportion is 14.7%.

Volunteers and Carers

Sources: Greater Manchester State of the VCSE Sector 2017: A Report on Social and Economic Impact, Sheffield Hallam University/Centre for Regional Economic and Social

Research

Greater Manchester Baselining and Best Practice Review, GMHSCP and Social Care Institute for Excellence | 50

Page 51: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

• All districts in GM have

seen a rise in the

numbers of people

caring for others over the

course of the decade

between 2001 and 2011.

• Manchester has the

highest number of carers

overall, over 42,000 of

them, and also

experienced by largest

rise in numbers over the

decade.

• However, as a proportion

of the local population,

the presence of carers is

higher in districts such

as Wigan (11%

compared with 8% in

Manchester).

• Overall, about 10% of

the population provide

care – slightly above the

national average.

Figure 30: Number of carers in GM, 2001-2011

280,000 GM residents have caring responsibilities

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

45,000

Bolton Bury Manchester Oldham Rochdale Salford Stockport Tameside Trafford Wigan

Total numbers of carers in 2011 280,299 Total numbers of carers in 2001 257,739

Rise in number of carers in a decade: 22,560

Source: Greater Manchester Baselining and Best Practice Review, GMHSCP and Social Care Institute for Excellence | 51

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HSC WORKFORCE IN DISTRICTS

| 52

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• This section of the LMI report details expected patterns in total HSC employment at GM district level, using GMFM as its data

source. Once more the caveats that apply to all forecasts need to be borne in mind; the information represents estimates based

on available information and reasonable assumptions and is thus subject to uncertainty.

• The information needs to be digested in conjunction with ‘workforce and transformation plans’ in each district. A summary of

these locality plans can be found in the Workforce Strategy and Implementation Plan 2017/18.

• Manchester accounts for the largest share of this growth – about 5,800 additional employees. Ranked in order of total staff

growth the other districts are as follows: Salford (2,200); Stockport (1,900); Bury (1,200); Bolton (1,000); Trafford (900); Oldham

(600); Wigan (600); and Tameside (270).

• Rochdale, however, stands out as the GM district that is forecast to shed some HSC labour. By 2035, GMFM anticipates that it

will have slightly fewer staff working in social care than in 2017 – albeit only slightly fewer (about 200). The pattern of growth in

HSC employment is clearly tilted more towards the south and west of the GM city region.

• In percentage terms, the three districts that are forecast to see the sharpest growth in their HSC workforces between 2017 and

2035 are Salford (14.6%); Manchester (12.2%); and Stockport (10.2%).

• As the charts in the following section demonstrate, labour market patterns are relatively consistent (with the exception of

Rochdale). In the five years from 2017 most districts are forecast to shed some staff numbers – albeit generally in only relatively

small numbers.

• After 2021 however growth in staff numbers becomes widespread with some districts adding numbers steadily. Typically, HSC

staff in GM will rise by about 7% between 2021 and 2035. Some districts such as Salford (just over 11%) will see much more

rapid growth.

• The sites of major hospitals are likely to be the principal reason behind patterns of change. Manchester is anticipated to account

for 28.7% of HSC employment in 2035 (compared with 27.1% today). Stockport will account for 10.7% (compared with 10.5%

today). And Salford will account for 9.2% (compared with 8.7% today). These three districts are forecast to increase their share

of GM’s HSC workforce. All other districts will reduce their share of GM’s HSC labour force (except Bury which will stay the same

accounting for 8% of the HSC workforce in GM).

HSC Workforce in Districts: Section Summary

| 53

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0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

Bolton Bury Manchester Oldham Rochdale Salford Stockport Tameside Trafford Wigan

861 : Hospital activities

862 : Medical and dental practice activities

869 : Other human health activities

871 : Residential nursing care activities

872 : Residential care activities for learning disabilities, mental health and substance abuse

873 : Residential care activities for the elderly and disabled

879 : Other residential care activities

881 : Social work activities without accommodation for the elderly and disabled

889 : Other social work activities without accommodation

• The prominence

of Manchester’s

hospitals

accounts for its

prevalence in

terms of the

large number of

employees in

health hospital

activities.

• Bury stands out

for its substantial

number of

employees

(2,600) working

in residential

care for people

with learning

disabilities,

mental health

issues or

substance

abuse.

Figure 31: Subsectors of the HSC labour market in districts, 2015

Hospital work focussed on south and west of the city region

Source: ONS BRES 2015 | 54

Page 55: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

Source: GMFM

• GMFM anticipates that in

Bolton there will be a very

slight rise in HSC staff

between 2017 and 2021 –

approximately 125 (0.7%).

• After this point more rapid

growth in staff numbers is

anticipated.

• Between 2021 and 2035

about 1000 more staff will be

employed in the sector (6%).

• By 2035, total staff working in

HSC in Bolton will be about

17,200.

Bolton

15

15.5

16

16.5

17

17.5

18

2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035

Emp

loym

ent

in H

SC (

00

0)

Figure 32: HSC Workforce Projections in Bolton, 2017-2035

| 55

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• GMFM anticipates that in

Bury there will be a modest

rise in HSC staff between

2017 and 2021 –

approximately 150 (1.1%).

• After this point, there will be a

relatively large growth in staff

numbers as about 1100 more

are added in Bury.

• By 2035 the HSC workforce

will comprise about 15,200

people (8% growth between

2021 and 2035).

Bury

13

13.5

14

14.5

15

15.5

16

2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035

Emp

loym

ent

in H

SC (

00

0s)

Figure 33: HSC Workforce Projections in Bury, 2017-2035

| 56Source: GMFM

Page 57: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

• GMFM anticipates that in

Manchester there will be a

large rise in HSC staff

between 2017 and 2021 –

approximately 1400 (a 3.0%

increase).

• After this point there will be a

further substantial growth of

staff as about 4400 more are

added in Manchester to take

the HSC workforce to 53,400

(a 9.0% increase between

2021 and 2035).

Manchester

45

46

47

48

49

50

51

52

53

54

55

2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035

Emp

loym

ent

in H

SC (

00

0)

Figure 34: HSC Workforce Projections in Manchester, 2017-2035

| 57Source: GMFM

Page 58: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

• GMFM anticipates that in

Oldham there will be a small

drop in staff followed by a

rise.

• Comparing 2017 and 2021

total numbers working in

HSC will be virtually

unchanged.

• After 2021 modest growth in

staff numbers is projected.

• About 600 more staff (4.3%

increase) will be added.

• By 2035 about 15,800 will be

employed by the HSC sector

in Oldham.

Oldham

14

14.5

15

15.5

16

16.5

17

2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035

Emp

loym

ent

in H

SC (

00

0s)

Figure 35: HSC Workforce Projections in Oldham, 2017-2035

| 58Source: GMFM

Page 59: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

• Rochdale stands out as the

district in Greater Manchester

with notably different HSC

workforce projections than

the others.

• GMFM anticipates that in

Rochdale, there will be a

decline in HSC staff between

2017 and 2021 of

approximately 120 (1.3%).

• After this point, there will be

some growth of staff and

then a moderate decline.

• Between 2021 and 2035 total

staff in HSC will decline by

about 130 (-2.7%).

• By 2035 the Rochdale HSC

workforce will total about

9,080.

• According to GMFM,

Rochdale is alone in seeing a

fall in the HSC workforce out

of the 10 GM districts in

comparison with the total in

2017.

Rochdale

8

8.2

8.4

8.6

8.8

9

9.2

9.4

9.6

9.8

10

2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035

Emp

loym

ent

in H

SC (

00

0s)

Figure 36: HSC Workforce Projections in Rochdale, 2017-2035

| 59Source: GMFM

Page 60: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

• GMFM anticipates that in

Salford, there will be a

modest rise in HSC staff

between 2017 and 2021 –

approximately 450 (3.0%).

• After this point, there will be a

substantial growth of staff, as

almost 1800 more are added

in Salford to take the Salford

HSC workforce to 17,600 by

2035.

• According to GMFM, Salford

will experience among the

sharpest growth rates of any

of the GM districts adding

11.1% more HSC staff

between the years of 2021

and 2035.

• It is the districts in the South

and West of the conurbation

of Greater Manchester that

appear to be likely to

increase their HSC

workforces most significantly:

Salford, Stockport and

Manchester.

Salford

15

15.5

16

16.5

17

17.5

18

2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035

Emp

loym

ent

in H

SC (

00

0)

Figure 37: HSC Workforce Projections in Salford, 2017-2035

| 60Source: GMFM

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• GMFM anticipates that in

Stockport, there will be a

modest rise in HSC staff

between 2017 and 2021 –

approximately 250 (1.4%).

• After this point there will be a

substantial growth of staff, as

about 1600 more are added

in Stockport to take the

Stockport HSC workforce to

20,400 between 2021 and

2035 (8.6% increase).

Stockport

17

17.5

18

18.5

19

19.5

20

20.5

21

2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035

Emp

loym

ent

in H

SC (

00

0s)

Figure 38: HSC Workforce Projections in Stockport, 2017-2035

| 61Source: GMFM

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• GMFM anticipates that in

Tameside there will be a

slight decline in HSC staff

between 2017 and 2021.

• After this point, there will be a

modest growth of staff.

• Numbers will rise by about

300 in the years between

2021 and 2035 (2.8%).

• In 2035, the Tameside HSC

workforce is likely to total

about 11,900.

Tameside

10.5

10.7

10.9

11.1

11.3

11.5

11.7

11.9

12.1

12.3

12.5

2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035

Emp

loym

ent

in H

SC (

00

0s)

Figure 39: HSC Workforce Projections in Tameside, 2017-2035

| 62Source: GMFM

Page 63: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

• GMFM anticipates that in

Trafford there will be a

modest rise in HSC staff

between 2017 and 2021 –

approximately 150 (1.3%).

• After this point, forecasts

suggest relatively substantial

increase of 750 staff between

2021 and 2035 (6.8%) to

take the Trafford HSC

workforce to 12,000 by 2035.

Trafford

10.5

11

11.5

12

12.5

2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035

Emp

loym

ent

in H

SC (

00

0s)

Figure 40: HSC Workforce Projections in Trafford, 2017-2035

| 63Source: GMFM

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• GMFM anticipates that in

Wigan there will be a minute

decline in the total number of

HSC staff in Wigan between

2017 and 2021 -

approximately 20.

• After this point, there will be a

modest growth of staff, as

just over 600 more are added

in Wigan between 2021 and

2035 (3.7%) to take the

Wigan HSC workforce to

17,500 by 2035.

Wigan

15

15.5

16

16.5

17

17.5

18

2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035

Emp

loym

ent

in H

SC (

00

0s)

Figure 41: HSC Workforce Projections in Wigan, 2017-2035

| 64Source: GMFM

Page 65: GM Health and Social Care Workforce: Labour Market ... · •Devolution and Health and Social Care: Along with powers over housing, skills and transport, the 'Devo Manchester' deal

• GMHSC Workforce Strategy and Implementation Plan, July 2017 http://www.gmhsc.org.uk/assets/13-Workforce-Strategy-and-

Implementation-Plan-SPB-28.07.2017-combined-FINAL-v1.0.pdf

• GMHSC Taking Charge – 5 year plan, December 2015 http://www.gmhsc.org.uk/assets/GM-Strategic-Plan-Final.pdf

• GMHSC Taking Charge: Implementation and Delivery Plan, October 2016 http://www.gmhsc.org.uk/assets/GM-STP-3-Implementation-

Delivery-Narrative-FINAL-251116.pdf

• New Economy, Deep Dive 05: Health and Social Care and Health Innovation http://www.neweconomymanchester.com/media/1759/05-

hs-and-health-innovation-deep-dive-report-final.pdf

• Greater Manchester Forecasting Model http://www.neweconomymanchester.com/publications/greater-manchester-forecasting-model

• New Models of Homecare for Older People in the North West https://nwemployers.org.uk/wp-content/uploads/2016/09/New-Models-of-

Older-Peoples-Home-Care-North-West.pdf

• Greater Manchester State of the VCSE Sector 2017 https://www.gmcvo.org.uk/greater-manchester-state-vcse-sector-2017

• Skills for Health: Health Sector Workforce Intelligence Reports http://www.skillsforhealth.org.uk/resources/reports/research-and-

intelligence-library/health-sector-workforce-intelligence-national-reports

• For further information, please contact the GMCA research team via: [email protected]

Links and references to related documents

| 65